NPIMap

Individual provider Active NPI

Jayasankar K Reddy, MD

  • Nephrology Physician
  • Wichita Falls, TX
National Provider Identifier
1174562276
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N6404 Issued in TX
Practice address
4412 Kell Blvd
Wichita Falls, TX 76309-4719
Phone
(940) 716-0557
Fax
(940) 355-0028
NPI assigned
Jun 5, 2006
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N6404 TX
Nephrology Physician 207RN0300X N6404 TX Primary

Addresses

Primary practice location

4412 Kell Blvd
Wichita Falls, TX 76309-4719

Mailing address

4412 Kell Blvd
Wichita Falls, TX 76309-4719
Phone (940) 716-0557

Other identifiers 2

IdentifierTypeStateIssuer
213626901MedicaidTX
213626902MedicaidTX

Other names 1

  • Jayasankar R Kaluvapalle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728000615 TX Practitioner - NephrologyPractitioner - Internal Medicine 2062460827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4412 Kell Blvd
Wichita Falls, TX 76309-4728
Phone (940) 716-0557

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
N6404TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Jose Audie E Lim, M.D.,P.a. Internal Medicine Current Accepting new patients
Wichita Falls Kidney Clinic PA Internal Medicine CurrentSince Dec 1, 2012 Accepting new patients
Wichita Falls Kidney Dialysis LLC CurrentSince Jul 15, 2016 Accepting new patients
Seton Hospitalist Service Internal Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ascension Seton Internal Medicine Past Accepting new patients
Emergency Physicians of Northwest Ohio, LLC Past Accepting new patients
Austin Nephrology Associates, PA Nephrology Past Accepting new patients
Emergency Physicians Integrated Care, LLC Past Accepting new patients
Division of Nephrology University of Utah Internal Medicine PastSince Jul 10, 1990 Accepting new patients
Dialysis Program Physicians University of Utah PastSince Jul 8, 2018 Accepting new patients
Dolores County Health Association Past Accepting new patients

Locations

1104 Holliday St
Wichita Falls, TX 76301
Phone (940) 257-8068

1508 10th St
Ste B
Wichita Falls, TX 76301
Phone (940) 322-4480

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

1600 9th St
Wichita Falls, TX 76301
Phone (940) 322-1450

4412 Kell Blvd
Wichita Falls, TX 76309
Phone (940) 696-0011

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: jreddy14541@unitedregional.medalliesdirect.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1174562276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094719",
            "telephone_number": "940-716-0557",
            "fax_number": "940-355-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094719",
            "telephone_number": "940-716-0557",
            "fax_number": "940-355-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "JAYASANKAR",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6404",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N6404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213626901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213626902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYASANKAR",
            "last_name": "KALUVAPALLE",
            "middle_name": "R",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.